The Brain Revolution and Ethics

By Arthur L. Caplan

No area of science is commanding more ethical attention these days than genetics. No other area of science with potential application to plants, animals, and people can match the speed with which new knowledge is being created in genetics. But lurking over in the disciplinary corner--somewhat out of sight of the ethicists' gaze--are the neurosciences. Advances in radiology, psychiatry, neurology, neurosurgery, bioengineering, and psychology are furthering our understanding of animal and human brains almost as quickly as genomics is fueling genetics.

The brain revolution promises to be very controversial ethically. Already, some lawyers are trying to submit brain scans as evidence of their clients' lack of responsibility for crimes; government agencies are thinking about scanning the heads of prospective military pilots, astronauts, and secret agents to see who might be predisposed to what; doctors are implanting devices directly into the brain to help patients cope with parkinsonism or epilepsy; and many high-school kids who have no obvious learning disabilities are swallowing Ritalin and other drugs along with their coffee and tea to try to get an edge when they take their exams or scholastic aptitude tests.

I think we're a little puritanical about the idea of mucking with our heads. Americans in particular have the belief that you should earn what you get, and that if you take a pill or use a surgical scalpel or drop in an implant, somehow you've cheated. But is it really wrong if altering the brain makes it possible to perform better, achieve more, or have greater capacities than one's parents? Here are some of the arguments I've heard that say it is wrong. I am not sure any of them are all that persuasive.

Many people believe that enhancement or improvement would simply be unfair. Some people would get an improved brain and some people wouldn't. Well, it is certainly possible--in fact, likely--that if nothing is done to ensure access, then inequities will exist with respect to the ability to use technology to improve the brain. But as Stanley Kaplan courses, music camps, and fancy private high schools should remind us, access to things that advantage the brain is currently unfair. That doesn't make inequity right. But, the solution is to provide fair access to things that can enhance our minds--be they teachers or implantable chips--not to do away with the idea of improvement. Assuring equal access to the rich and the poor is a problem, but it's not one that is inherent in improvement. Nor is unequal access an argument against improvement; it's an argument against inequity.

Another objection to tweaking our neurons is that the equality of human beings might be threatened if you start to let some people become advantaged. The equality of human beings does not presuppose, however, biological equality. It is instead a claim about moral worth that goes beyond particular attributes, properties, and behaviors. It is, if you will, a normative stance about how all human beings ought to be treated, smart or not, able-bodied or not. It is simply fallacious to argue that our notion of human equality depends on biological equality. If it did we would already be in trouble.

A third argument is that it's wrong to improve our minds because it would further disadvantage those who are the least well-off. People with mental retardation or mental illness do not fare well today in most societies, and opening bigger gaps between them and the rest of us will lead to even more problems.

Well, there is always a risk of discrimination, but disability and difference confront us now, and there's no reason why people who are different should be foreclosed from using interventions to improve or enhance brain function. It is arguable that disadvantaged people should have first claim on enhancement resources if they choose to use them. And there is no reason to think that improving our memory capacity will make anyone feel any less tolerant of those with Alzheimer. Discrimination or neglect of those with Alzheimer is unethical regardless of whether you have an average memory or an enhanced memory capacity.

A last objection: Brain engineering is just unnatural. This is an argument that Leon Kass, the president's chief adviser on bioethics, has been promoting--it's wrong to intervene with our nature. He and some of his fellow travelers, such as William Kristol, Charles Krauthammer, and Francis Fukuyama, suggest that if we start to engineer ourselves, improve and enhance ourselves, we're going to become "posthuman."

The main flaw with this argument is that it is made by people who wear eyeglasses, use insulin, have artificial hips or heart valves, benefit from cell, tissue, or organ transplants, ride on airplanes, dye their hair, talk on phones, sit under electric lights and swallow vitamins. What are they really talking about? Are we posthuman if we ride but don't walk? We might be less healthy but does a reliance on technology to get around make us posthuman? I don't see the argument for a natural boundary or limit, beyond which our nature is defiled by technology. This line of thinking is a grave threat that leads directly back to the rejection not only of engineering our brains but also of all of medicine.

I don't think the arguments are as persuasive as they ought to be against trying to improve our brains. I, for one, await the day when my neuroscience friends give me some ways to do it.

Arthur L. Caplan, Ph.D., is director of the Center for Bioethics, University of Pennsylvania.

2002, The Scientist Inc.

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